Tretinoin Capsules are a vitamin A derivative (retinoid), mainly used for the treatment of specific types of acute promyelocytic leukemia (APL). As a differentiation inducer, it exerts its therapeutic effect by promoting the maturation and apoptosis of leukemia cells.

How Effective is Tretinoin Capsules in Treatment?

Inducing Differentiation of Leukemia Cells

Tretinoin Capsules can induce abnormal promyelocytes to differentiate into mature neutrophils, thereby reducing the proliferation of malignant cells.

In the early stage of treatment, an increase in peripheral blood leukocyte count is often observed, which is one of the signs that the drug is taking effect.

Synergistic Effect of Combined Therapy

It usually needs to be used in combination with anthracycline chemotherapeutic drugs to consolidate the therapeutic effect and reduce the risk of recurrence.

During treatment, close monitoring for adverse reactions such as differentiation syndrome is required.

Applicable Populations of Tretinoin Capsules

Patients with Classic APL

Confirmation of diagnosis requires cytogenetic testing (t(15;17) translocation) or molecular testing (PML/RARα fusion gene); morphological diagnosis is only used as a preliminary basis.

Patients with Treatment Failure or Contraindications

Adult patients and pediatric patients aged ≥1 year who are resistant to anthracycline chemotherapy or have relapsed after treatment.

Patients with contraindications to anthracycline chemotherapy (e.g., risk of cardiotoxicity).

Medication Monitoring for Tretinoin Capsules

Monitoring of Treatment Response

Conduct a complete blood count (CBC) weekly, and pay attention to changes in leukocyte count (which may increase rapidly).

Perform bone marrow aspiration to evaluate the differentiation status of cells.

Monitoring of Adverse Reactions

Differentiation Syndrome: Monitor for symptoms such as fever, dyspnea, and weight gain; immediate glucocorticoid treatment is required if this syndrome occurs.

Intracranial Hypertension: For pediatric patients, focus on monitoring neurological symptoms such as headache and papilledema.

Dyslipidemia: Regularly test fasting triglyceride and cholesterol levels.

Monitoring of Organ Function

Liver Function: Conduct baseline testing and regular monitoring of transaminases during treatment.

Electrocardiogram (ECG): Cardiac monitoring is required for patients at risk of QT interval prolongation.

Management of Drug Interactions

Avoid combined use with potent CYP3A4 inhibitors (e.g., ketoconazole) or inducers (e.g., rifampicin).

Combined use with vitamin A preparations or other drugs that cause intracranial hypertension (e.g., tetracyclines) is prohibited.